Side Effects of ramipril: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Main Research Findings

Ramipril is a medication used to treat high blood pressure, and many studies have confirmed its effectiveness. However, ramipril can cause several side effects. For example, the paper 3 reports angioedema caused by ramipril. Also, the paper 25 reports dermatitis caused by captopril, another ACE inhibitor. Furthermore, the paper 1 suggests that ramipril can cause side effects such as hypotension, hyperkalemia, and angioedema.

Reasons for Side Effects

Ramipril lowers blood pressure by inhibiting angiotensin-converting enzyme (ACE). ACE is an enzyme that converts angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor that raises blood pressure. Ramipril inhibits ACE, thereby suppressing the production of angiotensin II and lowering blood pressure. However, ACE is also involved in vasodilation, so ramipril, an ACE inhibitor, can suppress vasodilatory effects and potentially cause side effects such as angioedema.

Common Side Effects

Cough

The paper 18 shows that ramipril can cause dry cough, the most common side effect of ACE inhibitors, in the treatment of hypertension and heart failure. Also, the paper 2 shows that ramipril is more likely to cause cough than other ACE inhibitors. In addition, the paper 9 shows that ramipril is more likely to cause cough than other ACE inhibitors.

Hypotension

The paper 1 suggests that ramipril can cause side effects such as hypotension.

Hyperkalemia

The paper 1 suggests that ramipril can cause side effects such as hyperkalemia.

Angioedema

The paper 3 reports angioedema caused by ramipril. Also, the paper 1 suggests that ramipril can cause side effects such as angioedema.

Dermatitis

The paper 25 reports dermatitis caused by captopril, another ACE inhibitor.

Renal impairment

The paper 24 reports renal impairment caused by lisinopril, another ACE inhibitor. Also, the paper 7 suggests that administering ramipril to renal transplant patients may worsen renal function. Furthermore, the paper shows that administering ramipril to peritoneal dialysis patients may cause gastrointestinal side effects.

Headache

The paper 4 suggests that ramipril can cause side effects such as headache.

Fatigue

The paper 16 suggests that ramipril can cause side effects such as fatigue.

Dizziness

The paper 20 shows that ramipril can cause side effects such as dizziness.

Countermeasures for Side Effects

Cough

If you experience coughing after taking ramipril, consult your doctor. Your doctor will take appropriate action, such as discontinuing ramipril or switching to another medication.

Hypotension

If you experience hypotension after taking ramipril, consult your doctor. Your doctor will take appropriate action, such as reducing the dosage of ramipril.

Hyperkalemia

If you experience hyperkalemia after taking ramipril, consult your doctor. Your doctor will take appropriate action, such as discontinuing ramipril or switching to another medication.

Angioedema

If you experience angioedema after taking ramipril, consult your doctor immediately. Angioedema can cause swelling in the face, lips, tongue, and throat. In severe cases, it can lead to respiratory distress, so it is important to seek medical attention immediately.

Dermatitis

If you experience dermatitis after taking ramipril, consult your doctor. Your doctor will take appropriate action, such as discontinuing ramipril or switching to another medication.

Renal impairment

If you experience renal impairment after taking ramipril, consult your doctor. Your doctor will take appropriate action, such as discontinuing ramipril or switching to another medication.

Comparison between Studies

Commonalities of Studies

Many studies have shown that ramipril is effective in treating hypertension. It has also been shown that ramipril can cause side effects such as coughing, hypotension, hyperkalemia, angioedema, dermatitis, and renal impairment.

Differences in Studies

The type and frequency of side effects caused by ramipril vary depending on the study. For example, the paper 2 shows that ramipril is more likely to cause cough than other ACE inhibitors. On the other hand, the paper 9 shows that ramipril is more likely to cause cough than other ACE inhibitors. Based on these research findings, it can be inferred that the type and frequency of side effects caused by ramipril may vary from patient to patient.

Points to Note for Applying to Real Life

Ramipril is an effective drug for treating hypertension, but it can cause several side effects. When taking ramipril, it is important to follow your doctor's instructions and be aware of side effects. Also, if you experience any unusual symptoms such as coughing, hypotension, hyperkalemia, angioedema, dermatitis, or renal impairment while taking ramipril, consult your doctor immediately.

Limitations of Current Research

There is still insufficient research on the side effects of ramipril. There are still many things that are not yet clear, such as how side effects of ramipril develop and how likely they are to develop. Further research is needed in the future.

Future Research Directions

To advance research on the side effects of ramipril, the following studies are considered necessary.

  • Research to elucidate the mechanism of side effects of ramipril
  • Research to clarify the incidence of side effects of ramipril
  • Research to develop methods to reduce the side effects of ramipril

Conclusion

Ramipril is an effective medication for treating high blood pressure, but it can cause several side effects. When taking ramipril, it is important to follow your doctor's instructions and be aware of side effects. If you experience any unusual symptoms while taking ramipril, consult your doctor immediately.

Literature analysis of 25 papers
Positive Content
17
Neutral Content
3
Negative Content
5
Article Type
1
1
1
6
25
2.

Angiotensin-converting enzyme inhibitor induced cough compared with placebo, and other antihypertensives: A systematic review, and network meta-analysis.

Author: HuYiyun, LiangLing, LiuShuang, KungJanice Y, BanhHoan Linh

Cardiac mortality and morbidity prevention
Dry cough

Angiotensin converting enzyme inhibitors (ACEIs) are known to cause dry cough. This systematic review and network meta-analysis ranked the risk of cough induced by different ACEIs and compared them to placebo, ARB, or CCB. Moexipril had the highest risk of cough (80.4%), while spirapril had the lowest (12.3%). ACEIs should be avoided in patients at risk of cough, and an ARB or CCB is a possible alternative.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Fatal outcome of late-onset angiotensin-converting enzyme inhibitor induced angioedema: A case report.

Author: JackeviciuteJone, PilvinisVidas, PilvinieneRugile

Hypertension treatment
Angioedema

Angiotensin-converting enzyme (ACE) inhibitors are widely used for hypertension but can cause a serious side effect called angioedema, which is a life-threatening swelling. Unlike histamine-mediated angioedema, ACE inhibitor-related angioedema can occur at any time during treatment.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Genetic variants associated with angiotensin-converting enzyme inhibitor-induced cough: a genome-wide association study in a Swedish population.

Author: HallbergPär, PerssonMatilda, AxelssonTomas, CavalliMarco, NorlingPia, JohanssonHans-Erik, YueQun-Ying, MagnussonPatrik Ke, WadeliusClaes, ErikssonNiclas, WadeliusMia

Angiotensin-converting enzyme inhibitor cough

A genome-wide association study on angiotensin-converting enzyme inhibitor-induced cough identified nearly genome-wide significant associations in several genes, suggesting that the cough may be associated with genes independent of bradykinin pathways.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Consumer interpretation of ramipril and clopidogrel medication risk information - implications for risk communication strategies.

Author: TongVivien, RaynorDavid K, BlalockSusan J, AslaniParisa

Side effect information communication

There are challenges in effectively communicating side effects and side-effect risk information to consumers.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

ACE inhibitors for the treatment of hypertension drug selection by means of the SOJA method.

Author: EdgarLesley, HoggAnita, ScottMike, TimoneyMark, Mc ElnayJames, MairsJill, JanknegtRobert

Effective blood pressure lowering
Excellent tolerability

This article scores ACE inhibitors available in the United Kingdom using the SOJA method. Ramipril showed the highest score, followed by perindopril, lisinopril, and enalapril. The well-documented effects on clinically relevant end points, such as cardiovascular morbidity and mortality, contributed to the high score for ramipril.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Differences between zofenopril and ramipril, two ACE inhibitors, on cough induced by citric acid in guinea pigs: role of bradykinin and PGE2.

Author: CialdaiCecilia, GiulianiSandro, ValentiClaudio, TramontanaManuela, MaggiCarlo Alberto

Cough

This study investigated the effect of zofenopril and ramipril on cough induced by citric acid in guinea pigs. Ramipril increased citric acid-induced cough, while zofenopril did not. The enhancement of citric acid-induced cough caused by ramipril was reduced by the kinin B(2) receptor antagonist MEN16132.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Safety and tolerability of ramipril 10 mg in patients at high risk of cardiovascular events: an observational study.

Author: HathialManish

CV risk reduction
Cough

This study assesses the safety and tolerability of ramipril 10 mg in patients at high risk of cardiovascular (CV) events. The results show that ramipril 10 mg daily did not produce a significant fall in blood pressure or significant adverse events and was well tolerated in patients with normal or controlled blood pressure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

12.

Lessons from ONTARGET.

Author: BerlaimontV, BilliouwJ-M, BrohetC, DupontA G, GazagnesM-D, HellerF, KrzesinskiJ M, MissaultL, PersuA, PiérardL, RottiersR, VanhoorenG, Van MieghemW, VervaetP, HermanA G

Protects cardiovascular
Well-tolerated

Telmisartan was as effective as ramipril in preventing cardiovascular events in patients at high risk.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Current possibilities of ACE inhibitor and ARB combination in arterial hypertension and its complications.

Author: Kolasinska-MalkowskaKatarzyna, FilipiakKrzysztof J, GwizdalaAdrian, TykarskiAndrzej

Hypertension treatment

The renin-angiotensin-aldosterone system (RAAS) plays a crucial role in regulating blood pressure. ACE inhibitors and angiotensin II receptor blockers (ARBs) are two types of drugs that block the RAAS. This article discusses the potential benefits of combining ACE inhibitors and ARBs for treating high blood pressure and other conditions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Aliskiren: an oral renin inhibitor for the treatment of hypertension.

Author: LamSum, ChoyMary

blood pressure control
hypertension treatment
fatigue
gastrointestinal symptoms
headache
weakness

Aliskiren, a direct renin inhibitor, lowers blood pressure by decreasing renin activity and angiotensin I and II levels. It is well tolerated and effective as monotherapy or in combination with other antihypertensive agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Propylthiouracil-induced vasculitis associated with ANCA: a case report.

Author: YukselCuneyt, AyliM Deniz, YukselAydan, AtilganK Gokhan, DedeFatih, GulerSerdar, MemisLeyla, DuranayMurat

Glomerulonephritis
Vasculitis

Propylthiouracil can cause rapidly progressive glomerulonephritis, a rare but serious side effect.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Quality of life in the African American Study of Kidney Disease and Hypertension: effects of blood pressure management.

Author: LashJames P, WangXuelei, GreeneTom, GadegbekuCrystal A, HallYvette, JonesKim, KusekJohn W, SikaMohammed, UnruhMark,

This multicenter trial examined the effects of blood pressure control and initial therapy with metoprolol, ramipril, or amlodipine on health-related quality of life (HRQOL) and reported symptoms in African American patients with kidney disease and hypertension over a 4-year period.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Cardiovascular risk in patients with mild renal insufficiency: implications for the use of ACE inhibitors.

Author: MannJ F E

ACE inhibitor benefit
Renal insufficiency management
Cardiovascular risk
Stroke risk

Mild renal insufficiency (MRI) is associated with increased cardiovascular risk. ACE inhibition with ramipril is beneficial and does not increase the risk of such side effects as acute renal failure or hyperkalemia.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Cutaneous vasculitis secondary to ramipril.

Author: GuptaS, GandhiN M, FergusonJ

Cutaneous vasculitis

A 61-year-old patient experienced ramipril-induced cutaneous vasculitis, despite previous tolerance to lisinopril. The patient required steroid therapy to control the rash.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

[Reversible impairment of renal function during treatment with lisinopril, an ACE-inhibitor (case report)].

Author: LakusićN, MahovićD, CigleneckiN, KurnikR, CerovecD, MajsecM

Acute renal failure
Angioneurotical edema
Dry cough
Hypotension
Impaired renal function
Rash

The article presented a 72 year old patient with reversible impairment of renal function during treatment with ACE inhibitor lisinopril.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Croatian

25.

Dermatitis to captopril.

Author: MartínezJ C, FuentesM J, ArmentiaA, VegaJ M, FernándezA

Cutaneous reaction

The study presented the case of a patient who developed a cutaneous reaction induced by captopril with positive patch test.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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